首发精神分裂症患者代谢异常分析及奥氮平对其影响  

Metabolic abnormality of patients with first-episode schizophrenia and effect of olanzapine on them

作　　者：吴小立[1] 李雷俊[1] 吴文涛[2] 康庄[3] 张晋碚[1] 

机构地区：[1]中山大学附属第三医院心理科,广州510630 [2]广州医学院第二附属医院心理科,广州510260 [3]中山大学附属第三医院放射科,广州510630

出　　处：《中华神经医学杂志》2011年第11期1160-1163,共4页Chinese Journal of Neuromedicine

基　　金：广东省科技计划项目基金（2009B080701080）;广东省科技计划项目基金（20118031800101）

摘　　要：目的探讨首发精神分裂症患者代谢异常的情况及非典型抗精神病药物奥氮平对此可能的影响。方法选取中山大学附属第三医院心理科自2010年2月至2011年2月收治的30例首发精神分裂症患者（病例组，予以奥氮平单药治疗4周）及40例健康者（对照组），分别在治疗前（基线）、后测定身高、体质量、腰围、臀围、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白AI（aPOAI）、载脂蛋白B100（aPOB100）、脂蛋白a（LPa）、空腹血糖（FBS）、空腹胰岛素（INS）及C肽，计算胰岛素抵抗指数（IR）、腰臀比（WHR）和体重指数（BMI），并将病例组与对照组、病例组治疗前后各项代谢指标进行比较分析。结果病例组HDL、aPOAI明显低于对照组，腰臀比、IR、1NS、C肽明显高于对照组，差异均有统计学意义（P〈0．05）。病例组治疗后BMI、腰围、腰臀比、胰岛素、IR、TC、TG、LDL、aPOB100较治疗前均有明显增高，差异均有统计学意义（P〈0．05）。结论精神分裂症患者本身可能存在某些代谢异常的易感素质．其高代谢异常发生率可能是其易感素质与抗精神病药物共同作用的结果。Objective To explore the metabolic abnormality in patients with first-episode schizophrenia and effect of atpical antipsychotics olanzapine on them. Methods Thirty patients with first-episode schizophrenia, admitted to our hospital from February 2010 to February 2011, and 40 healthy controls were chosen in our study; patient group was given oral olanzapine for 4 week. The height, weight, waistline and hipline were measured before and after treatment, and the total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein （HDL）, low-density lipoprotein （LDL）, apolipoprotein AI （aPOAI）, apolipoprotein B100 （aPOB100）, lipoprotein a （LPa）, fasting blood-glucose, fasting insulin and C peptide levels were detected before and after treatment; and the insulin resistance （IR） index, waist hip ratio （WHR） and body mass index （BMI） were calculated before and after treatment; metabolic index were compared between patients and controls, and patients before and after the treatment. Results The HDL and aPOA1 levels in patient group were significantly lower, and the WHR, IR index, fasting insulin and C peptide levels were obviously higher as compared with those in the controls （P〈0.05）. The BMI, waist circumference, WHR, the IR index, the insulin, TC, TG, LDL and aPOB100 levels after treatment were significantly increased as compared with those before treatment （P〈0.05）. Conclusion There may be some inborn metabolic abnormality factors in patients with first-episode schizophrenia; the high incidence of metabolic abnormality in patients with schizophrenia may be the result of combined action from antipsychotics and inherit susceptibility.

关 键 词：精神分裂症 代谢异常 奥氮平 

分 类 号：R749.3[医药卫生—神经病学与精神病学]